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Second Stage: From full dilation to delivery  Descent, flexion and internal rotation completed followed by extension of the baby’s head as it delivers.  Passive phase = head reaches pelvic floor (engagement, rotation and flexion are complete) – mum experiences a desire to push.  Active phase = mum pushes (valsava manoeuvre) – due to pressure of the head on the pelvic floor.  Delivery:  Perineum stretches and often tears!  Restitution = head rotates 90 o into transverse position – in which it entered the pelvis  Next contraction = shoulder delivered https://www.youtube.com/watch?v=duPxBXN4qMg The Peer Teaching Society is not liable for false or misleading information…

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Normal labour The Peer Teaching Society is not liable for false or misleading information… Third Stage: Time from delivery of fetus to delivery of placenta (approx. 15 mins)  Delivery of placenta and membranes and the control of bleeding  During this time uterine contractions occur to compress the blood vessels supplying the placenta.

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Complications & Emergencies Shoulder Dystocia  The mothers pelvis constricts the baby’s chest, and there is also often cord compression, thus asphyxiation is the main risk. -Usually acidosis and asphyxiation will set in after about 4-5 minutes in the shoulder dystocia position. Management: -Get mum into McRobert’s position -Try other manoeuvres – Rubin, Woodscrew -Maternal Symphisiotomy -Push the head back in – emergency c-section (last choice) The Peer Teaching Society is not liable for false or misleading information…